08/10/2021    Paul Kesselman, DPM

Why are Podiatry School Graduates Not Grasping Biomechanics (Kevin A. Kirby, DPM)

Two years ago at the APMA 2019 National, Karen
Langone, Jeffery Ross and I provided a morning
session on 21st Century Biomechanics. Not more than
75 DPMs attended that session with most being over
the age of 45. Few young podiatrists attended this
while other surgical courses were being offered.
During the intervening two years, I have posted a
similar LTE as Drs. Ritchie and Kirby, and have met
with Dr. Shapiro, whose recent article has spurred
this most recent conversation. Two years ago,
rather than receiving letters of support on actions
by which to resolve the issue, I received several
letters from academia, defending the courses they
taught at their various podiatric institutions,
rather than acknowledgement that there was an
issue. Several orthotic laboratories did however
acknowledge the "problem".

Dr. Kirby's recent LTE is spot on and is identical
to what I was taught over 40 years ago while a
student at ICPM.

Unfortunately, the current students today lose much
of what they are taught from the biomechanical
perspective because it is lost by the time they
graduate or after their first year of residency. My
initial experience as an attending in residency
programs, required that the resident complete a
biomechanical exam on every elective surgical
patient. That (and correct me if I am wrong) is
most often no longer the rule.

Dr. Kirby's LTE along with others, screams of the
need for a multi-faceted approach in order to fix
this problem. The time on this is ticking as other
professions in the past five years have presented
far more research papers than I have seen either in
the podiatry literature space or at meetings.
Research along with evidence-based medicine either
proving or disproving podiatric theories will
either support or bury us. Owning this research and
having the academic capable students and residents
is more needed now than ever.

Dr. Shapiro and I have met several times either in
person or via Zoom over the past two years and have
begun our own "think tank" on how to right the ship
and fix this problem. At this point we both know it
will require lots of logistics and financial
resources from a myriad of sources.

What is needed now is a focus on the future and not
a defensive posture on what you or your institution
has done. Obviously whatever has been done has been
insufficient. We need visionaries, fellowships,
research centers and those who have ideas on how to
move this discussion in the correct direction.

I applaud all who have written in who have
acknowledged the problem and are willing to address
it in a positive direction.

Paul Kesselman, DPM, Woodside, NY

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